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Form #609Surrogate Release and Hold Harmless Agreement
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Surrogate release and hold harmless agreement - free to use
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Surrogate release and hold harmless
agreement.
I, [Surrogate's name], referred to as
"Surrogate"), and [Surrogate's Husband's name], her Husband,
(referred to as "Husband"), have applied to _________, attorney at
law, to be considered as a surrogate to bear a child for [Natural Father's
name]. It is my desire to enter into the preceding fee paid Surrogate Parenting
Agreement where I will be artificially inseminated by a physician for the
purpose of becoming pregnant. Upon birth, we as Surrogate and Husband will
surrender our custody rights to the child in favor of [Natural Father's name],
the child's natural and biological father; and where necessary and permitted by
law, terminate all parental rights to the child.
I, [Surrogate's name], Surrogate, represent that I am
healthy, both physically and mentally, and that I am capable to the best of my
knowledge of conceiving and carrying a fetus to term.
We, [Surrogate's name] and [Surrogate's Husband's name],
as Surrogate and Husband, represent that we were married on [Date of Marriage],
and have cohabited together as man and wife since that date.
We, [Surrogate's name] and [Surrogate's Husband's name],
understand that several attempts at artificial insemination may be necessary,
and that _________, attorney at law, does not guarantee that pregnancy or full
term pregnancy will result from artificial insemination. We have been advised
and counseled as to the potential psychological implications on our marital and
family relationship that may result from the birth of a child through this
surrogate parenting procedure.
We, [Surrogate's name] and [Surrogate's Husband's name],
agree with and will comply with the following policies:
1.
We under no circumstances shall require that the identity of [Natural
Father's name] be divulged to us or to anyone else, and accordingly, forever
waive all rights, if any, that we may have as to the identity, address, or any
other information whatsoever concerning [Natural Father's name].
2.
We recognize that surrogate parenting is a relatively new procedure, that the
laws are unclear in many areas; we have retained our own independent legal
advisor.
3. We release
_________, attorney at law, from any and all liability and responsibility of
any nature whatsoever which may result from the complications of childbirth or
delivery, or from the birth of an infant abnormal in any respect, or from the
hereditary tendencies of that issue, or from any adverse consequences which may
arise in connection with, or as a result of the artificial insemination.
However, nothing in this release shall be construed
as
an attempt by _________ to exonerate himself [herself] or limit his [her]
liability in the event of personal malpractice.
_________[Surrogate]
_________[Husband]
[Date
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site.
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or any other commercial use is prohibited. This includes reposting forms from this
site to another site offering free legal or other document forms for download.
Please note that the donator may have included different usage terms regarding this
form, and you agree to abide by these terms. It is highly recommended that you have
a licensed attorney review any legal documents for which you are searching in order
to make sure that your needs are being properly and completely satisfied.
Your use of this site constitutes your acceptance of our terms of use and your agreement
to hold this site, its officers, employees and any contributors to this site harmless
for any damage you might incur from your use of any submissions contained on this
site. If you do not agree to the above terms, please do not proceed.
These forms are provided to assist business owners and others in understanding important
points to consider in different transactions. They are offered with the understanding
that no legal advice, accounting, or other professional service is being offered
by these documents or on this website. Laws vary in the different states. Agreements
acceptable in one state may not be enforced the same way under the laws of another
state. Also, agreements should relate specifically to the particular facts of each
situation. Therefore, it is important to consult legal counsel whenever utilizing
these forms. The Forms are not a substitute for legal advice YourFreeLegalForms.com
is not engaged in recommending or referring members on the site or making claims
about the competence, character or qualifications of its participating members.
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